Contentions: Thoracic strain with lumbar facet arthropathy L5-S1 (Increase), cervical strain (claimed as tendonitis of neck) (Increase), PTSD- personal trauma w/anxiety d/o and panic attacks (New), Pinfueculitis, bilateral eye (New), VBMS (New), Right ankle, stable joint, aterior talodibulat chronic strain (Increase)
My files are routed through the Houston Regional Office. During the QTC exam the Doctor only filled out the questioner and gave me an x-ray of my neck and back, no physical exam was conducted on either. My back was changed to thoracic strain with lumbar facet arthropathy, L5-S1 with IVDS and radiculopathy and my neck is still listed as a cervical strain and I was denied for increase and still I am rated at 10% for both ratings and the Doctor for the QTC verbally told me that both conditions has gotten worse in his medical opinion but as I stated no physical exam, range of motion or anything was conducted, just the questioner and an x-ray which I already had when I was previously awarded 10% for both service connected injuries, where a range of motion was conducted during those two exams. On my claim I also claimed two new conditions one for pinguecula in both eyes and PTSD and did not have a C&P for either. Both of those claims were also denied. I had a separate C&P exam conducted by QTC for the Right ankle, stable joint, aterior talodibulat chronic strain (Increase) and the Doctor for this exam was pretty confused and asking my rudely why I thought my condition had gotten worse and what was worse about it when I had already filled out the questioner provided by QTC for this exam which he had in front of him. My ankle recently rolled on me prior to the exam so during the exam it was swollen and he kept asking me why was my leg shaking when trying to do the range of motion test, and was I nervous which was causing my leg to shake. I told the examiner that I was in pain and trying my best to do the resistance test. This claim as well was denied so I was denied for all 5 claims. Both QTC exams one for the neck and back and the other for my right ankle were all conducted in the same QTC facility. So what should I do next? Should I file an appeal, reopen the case and see my Primary Care Physician and have him conduct a C&P exam for my neck and back? My neck is the main concern where I always have to pop it to relive the tension.
These decisions have made a big impact on how VA disability claims are handled, giving veterans more chances to get benefits and clearing up important issues.
Service Connection
Frost v. Shulkin (2017)
This case established that for secondary service connection claims, the primary service-connected disability does not need to be service-connected or diagnosed at the time the secondary condition is incurred 1. This allows veterans to potentially receive secondary service connection for conditions that developed before their primary condition was officially service-connected.
Saunders v. Wilkie (2018)
The Federal Circuit ruled that pain alone, without an accompanying diagnosed condition, can constitute a disability for VA compensation purposes if it results in functional impairment 1. This overturned previous precedent that required an underlying pathology for pain to be considered a disability.
Effective Dates
Martinez v. McDonough (2023)
This case dealt with the denial of an earlier effective date for a total disability rating based on individual unemployability (TDIU) 2. It addressed issues around the validity of appeal withdrawals and the consideration of cognitive impairment in such decisions.
I met with a VSO today at my VA Hospital who was very knowledgeable and very helpful. We decided I should submit a few new claims which we did. He told me that he didn't need copies of my military records that showed my sick call notations related to any of the claims. He said that the VA now has entire military medical record on file and would find the record(s) in their own file. It seemed odd to me as my service dates back to 1981 and spans 34 years through my retirement in 2015. It sure seemed to make more sense for me to give him copies of my military medical record pages that document the injuries as I'd already had them with me. He didn't want my copies. Anyone have any information on this. Much thanks in advance.
Caluza Triangle – Caluza vs Brown defined what is necessary for service connection. See COVA– CALUZA V. BROWN–TOTAL RECALL
This has to be MEDICALLY Documented in your records:
Current Diagnosis. (No diagnosis, no Service Connection.)
In-Service Event or Aggravation.
Nexus (link- cause and effect- connection) or Doctor’s Statement close to: “The Veteran’s (current diagnosis) is at least as likely due to x Event in military service”
VA has gotten away with (mis) interpreting their ambigious, , vague regulations, then enforcing them willy nilly never in Veterans favor.
They justify all this to congress by calling themselves a "pro claimant Veteran friendly organization" who grants the benefit of the doubt to Veterans.
This is not true,
Proof:
About 80-90 percent of Veterans are initially denied by VA, pushing us into a massive backlog of appeals, or worse, sending impoverished Veterans "to the homeless streets" because when they cant work, they can not keep their home. I was one of those Veterans who they denied for a bogus reason: "Its been too long since military service". This is bogus because its not one of the criteria for service connection, but simply made up by VA. And, I was a homeless Vet, albeit a short time, mostly due to the kindness of strangers and friends.
Hadit would not be necessary if, indeed, VA gave Veterans the benefit of the doubt, and processed our claims efficiently and paid us promptly. The VA is broken.
A huge percentage (nearly 100 percent) of Veterans who do get 100 percent, do so only after lengthy appeals. I have answered questions for thousands of Veterans, and can only name ONE person who got their benefits correct on the first Regional Office decision. All of the rest of us pretty much had lengthy frustrating appeals, mostly having to appeal multiple multiple times like I did.
I wish I know how VA gets away with lying to congress about how "VA is a claimant friendly system, where the Veteran is given the benefit of the doubt". Then how come so many Veterans are homeless, and how come 22 Veterans take their life each day? Va likes to blame the Veterans, not their system.
Question
tsowen
Recently I filed a claim for:
Claim Received: 03/06/2013
Claim Type: Compensation
Claim Closed: 02/01/2014
Contentions: Thoracic strain with lumbar facet arthropathy L5-S1 (Increase), cervical strain (claimed as tendonitis of neck) (Increase), PTSD- personal trauma w/anxiety d/o and panic attacks (New), Pinfueculitis, bilateral eye (New), VBMS (New), Right ankle, stable joint, aterior talodibulat chronic strain (Increase)
My files are routed through the Houston Regional Office. During the QTC exam the Doctor only filled out the questioner and gave me an x-ray of my neck and back, no physical exam was conducted on either. My back was changed to thoracic strain with lumbar facet arthropathy, L5-S1 with IVDS and radiculopathy and my neck is still listed as a cervical strain and I was denied for increase and still I am rated at 10% for both ratings and the Doctor for the QTC verbally told me that both conditions has gotten worse in his medical opinion but as I stated no physical exam, range of motion or anything was conducted, just the questioner and an x-ray which I already had when I was previously awarded 10% for both service connected injuries, where a range of motion was conducted during those two exams. On my claim I also claimed two new conditions one for pinguecula in both eyes and PTSD and did not have a C&P for either. Both of those claims were also denied. I had a separate C&P exam conducted by QTC for the Right ankle, stable joint, aterior talodibulat chronic strain (Increase) and the Doctor for this exam was pretty confused and asking my rudely why I thought my condition had gotten worse and what was worse about it when I had already filled out the questioner provided by QTC for this exam which he had in front of him. My ankle recently rolled on me prior to the exam so during the exam it was swollen and he kept asking me why was my leg shaking when trying to do the range of motion test, and was I nervous which was causing my leg to shake. I told the examiner that I was in pain and trying my best to do the resistance test. This claim as well was denied so I was denied for all 5 claims. Both QTC exams one for the neck and back and the other for my right ankle were all conducted in the same QTC facility. So what should I do next? Should I file an appeal, reopen the case and see my Primary Care Physician and have him conduct a C&P exam for my neck and back? My neck is the main concern where I always have to pop it to relive the tension.
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